The Use of Computerized Tomography Scans in Elective Knee and Hip Arthroplasty—What Do They Tell Us and at What Risk?

D’Amore, Taylor; Klein, Gregg R.; Lonner, Jess H.

doi:10.1016/j.artd.2022.03.008

Cited by 11 publications

(2 citation statements)

References 59 publications

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“…A compromise between image quality and radiation dose must be considered with the use of CT as it offers superior image resolution but at the expense of higher radiation dose deposited to the patient (18). This problem is exacerbated by the poor choice of CT parameters by clinicians and the lack of a single low-dose CT protocol (19).…”

Section: Image Quality Vs Radiation Dosementioning

confidence: 99%

The variability of CT scan protocols for total hip arthroplasty: a call for harmonisation

Ramesh,

Di Laura,

Henckel

et al. 2023

EFORT Open Reviews

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CT is the principal imaging modality used for the pre-operative 3D planning and assessment of total hip arthroplasty (THA). The image quality offered by CT has a radiation penalty to the patient. Higher than necessary radiation exposure is of particular concern when imaging young patients and women of childbearing age, due to the greater risk of radiation-induced cancer in this group. A harmonised low-dose CT protocol is needed, evidenced by the huge variability in the 17 protocols reviewed. The majority of the protocols were incomplete, leading to uncertainty among radiographers when performing the scans. Only three protocols (20%) were optimised for both ‘field of view’ and image acquisition parameters. 10 protocols (60%) were optimised for ‘field of view’ only. These protocols included imaging of the relevant landmarks in the bony pelvis in addition to the knees – the reference for femoral anteversion. CT parameters, including the scanner kilovoltage (kV), milliamperage–time product (mAs) and slice thickness, must be optimised with a ‘field of view’ that includes the relevant bony landmarks. The recommended kV and mAs values were very wide ranging from 100 to 150 and from 100 to 250, respectively. The large variability that exists amongst the CT protocols illustrates the need for a more consistent low-dose CT protocol for the planning of THA. This must provide an optimal balance between image quality and radiation dose to the patient. Current CT scanners do not allow for measurements of functional pelvic orientation and additional upright imaging modalities are needed to augment them.

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Section: Image Quality Vs Radiation Dosementioning

confidence: 99%

The variability of CT scan protocols for total hip arthroplasty: a call for harmonisation

Ramesh,

Di Laura,

Henckel

et al. 2023

EFORT Open Reviews

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“…obtaining correct rotation of femoral components (Hirschmann et al, 2011;Pietrzak et al, 2018). Computed tomography (CT) is state of the art for acquiring 3D bone models, but it exposes the patient to radiation (Brenner & Hall, 2007;D'Amore et al, 2022;Ponzio & Lonner, 2015) and is an expensive procedure. Another imaging technique is ultrasound (US).…”

Section: Introductionmentioning

confidence: 99%

3D Reconstruction of Femur using Ultrasound - Hand Guided Evaluation and Autonomous Robotic Approach

Phlippen,

Hohlmann,

Radermacher

EPiC Series in Health Sciences

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Total Knee Arthroplasty is a frequently performed surgery. Patient specific planning and implants may improve surgical outcome. For this purpose, 3D models of the bones are required, which are typically generated by using computed tomography. A radiation free and cheaper alternative could be ultrasound. However, bone segmentation and a competitive method of creating a complete bone model are a challenge.In this work a fully-automatic bone reconstruction pipeline using ultrasound, which includes machine learning based image segmentation and an interpolation algorithm for missing areas using statistical shape models, is presented and evaluation results with free hand probe guidance are outlined. A mean surface distance error of 0.96 mm for femur bone reconstruction is achieved. Furthermore, a robotic scanning approach is presented to automate the entire process. Autonomous scanning of the anterior distal femur was successful for 4 out of 5 probands. On average, 54 % of the accessed bone surface could be reconstructed.

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Computed Tomography and Arthrography

Fu,

Bahl,

Mansour

2024

Medical Radiology

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The Use of Computerized Tomography Scans in Elective Knee and Hip Arthroplasty—What Do They Tell Us and at What Risk?

Cited by 11 publications

References 59 publications

The variability of CT scan protocols for total hip arthroplasty: a call for harmonisation

The variability of CT scan protocols for total hip arthroplasty: a call for harmonisation

3D Reconstruction of Femur using Ultrasound - Hand Guided Evaluation and Autonomous Robotic Approach

Computed Tomography and Arthrography

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